Samples For all antibiotic assays, 5-10mls blood into red-topped tube (no anticoagulant) DO NOT sample from the line through which the antibiotic has been given. 

 

AntibioticSampling TimeFirst SampleExpected LevelsUsual interval to re-assay

 

VANCOMYCIN

 

Pre-dose only (i.e. within 15 mins before dose)

 

Around 2nd – 4th dose

5 – 15mg/L

3 days

 

GENTAMICIN / TOBRAMYCIN  (b.d or t.d.s regime)

Pre-dose (within 15 mins before dose)

and

Post-dose (1hr after dose)

Around 2nd – 4th dose

Pre less than 2mg/L

Post 5 – 10 mg/L

3 days

GENTAMICIN / TOBRAMYCIN (once – daily regime)Post-dose only taken between 6 and 14 hours after dose.

N.B. Times of dosing and sampling must be given on request form.

1st to 3rd dose

Interpretation by Microbiologist

3 days

Important Notes 

  1. After taking pre-dose levels, give the prescribed dose as normal – DO NOT wait for the results of the assay. 
  2. “Random” levels should seldom be needed and should only be taken by prior arrangement with the Duty Microbiologist. 
  3. For patients with stable renal function, whose results are within the expected range, assays do not need to be performed more than twice a week. Where renal function is unstable or poor, assays should be discussed with the Duty Microbiologist. 

General notes:  Blood is normally sterile and the presence of bacteria in the bloodstream (bacteraemia/septicaema) is a serious & potentially life-threatening condition. As even very small numbers of bacteria in the blood can cause severe illness, enough blood must be sampled to give the lab a chance of detecting them. Similarly, the techniques used to detect bacteria in blood are designed to pick up tiny numbers. This means that unless the samples are taken with great care & flawless aseptic technique, contaminants from the skin of patients or staff, cannulae or environment may be inoculated with the blood and give a positive result on culture.

It is often very difficult to distinguish contaminating bacteria from real pathogens and, in the best interests of the patient, each positive blood culture has to be telephoned to the relevant clinical team, by a microbiology registrar or consultant in order to assess the clinical implications. Often, patients have to be given antibiotics as a precaution, while a full identification of the bacterium is carried out.

Procedure

Is available on the HEFT Infection control site :  Procedure for taking Blood Cultures

 

Infertility Analysis

We provide a service by appointment only for infertility investigations. This service is
Provided at:

HEARTLANDS HOSPITAL

  • Tuesday afternoon
  • Wednesday afternoon

SOLIHULL HOSPTIAL

  • Monday early morning/afternoon
  • Thursday early morning/afternoon

Appointments should be made by the General Practitioner/Consultant or the Patient by telephoning (0121) 424 3236.The patient will be given an appointment time /date and instructions where to bring the sample. The patient will collect the sample at home and bring it at the appropriate time with a signed request form filled in by the clinician. A detailed instruction sheet is available upon request from the laboratory.

Intra-uterine Insemination

There are appointments at Solihull Hospital , 3 on  Monday morning and 3 on Thursday morning. These can only be made via the Clinicians at the Women's units at Solihull and Heartlands Hospital. They provide instructions to the patient on collection and delivery of the specimens.

Post Vasectomy Investigations

A service is provided at Heartlands Hospital for post vasectomy specimens. the patient is provided with instructions by the Clinician on the appropriate time scale for the production and collection of the specimen. The service is available during the normal working day Monday to Friday and no appointment is required

We participate in the UK NEQAS Andrology scheme and follow the World Health Organization standards for Seminal fluid analysis.

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